§ 27-81-4. Coverage of telemedicine services.
(a) Each health insurer that issues individual or group accident and sickness insurance
policies for healthcare services and/or provides a healthcare plan for healthcare
services shall provide coverage for the cost of such covered healthcare services provided
through telemedicine services, as provided in this section.
(b)(1) A health insurer shall not exclude a healthcare service for coverage solely because
the healthcare service is provided through telemedicine and is not provided through
in-person consultation or contact, so long as such healthcare services are medically
necessary and clinically appropriate to be provided through telemedicine services.
(2) All medically necessary and clinically appropriate telemedicine services delivered
by in-network primary care providers, registered dietitian nutritionists, and behavioral
health providers shall be reimbursed at rates not lower than services delivered by
the same provider through in-person methods.
(c) Benefit plans offered by a health insurer shall not impose a deductible, copayment,
or coinsurance requirement for a healthcare service delivered through telemedicine
in excess of what would normally be charged for the same healthcare service when performed
in person.
(d) Prior authorization requirements for medically necessary and clinically appropriate
telemedicine services shall not be more stringent than prior authorization requirements
for in-person care. No more stringent medical or benefit determination and utilization
review requirements shall be imposed on any telemedicine service than is imposed upon
the same service when performed in person.
(e) Except for requiring compliance with applicable state and federal laws, regulations,
and/or guidance, no health insurer shall impose any specific requirements as to the
technologies used to deliver medically necessary and clinically appropriate telemedicine
services.
(f) The requirements of this section shall apply to all policies and health plans issued,
reissued, or delivered in the state of Rhode Island on and after January 1, 2018.
(g) This chapter shall not apply to: short-term travel, accident-only, limited or specified
disease; or individual conversion policies or health plans; nor to policies or health
plans designed for issuance to persons eligible for coverage under Title XVIII of
the Social Security Act, known as Medicare; or any other similar coverage under state
or federal governmental plans.